In simple words: This code covers the cost of a very strong anti-cancer medicine called brentuximab vedotin, given through a drip into your vein. It is for adults with a type of cancer called Hodgkin's lymphoma that has spread to several parts of the body, and is used alongside other cancer treatments.

This J-code represents 1 mg of brentuximab vedotin administered via intravenous infusion. It is used in the treatment of adult patients with previously untreated stage III or IV classical Hodgkin lymphoma (cHL) in combination with other chemotherapy. The standard dose is 1.2 mg/kg up to a maximum of 120 mg every 2 weeks for 12 doses. Brentuximab vedotin is supplied as a 50 mg lyophilized powder in a single-dose vial.

Example 1: A 60kg adult patient with newly diagnosed stage IV classical Hodgkin lymphoma receives 72 mg (1.2 mg/kg) of brentuximab vedotin via IV infusion every 2 weeks as part of a combination chemotherapy regimen., A 80 kg adult patient with stage III classical Hodgkin lymphoma receives the maximum dose of 120 mg of brentuximab vedotin via IV infusion every two weeks, along with other chemotherapy drugs., A patient undergoing a clinical trial for Hodgkin’s lymphoma receives brentuximab vedotin, and modifier QO is appended to J9042 to indicate its investigational use.

Documentation should include the patient's diagnosis (stage III or IV classical Hodgkin lymphoma), weight, dose administered, date and time of administration, and any adverse reactions. Confirmation of the combination chemotherapy regimen being used is essential. If less than a full vial is used, documentation of the discarded amount and the use of modifier JW is necessary.

** This code represents the drug itself; administration may be billed separately using appropriate CPT codes (e.g., 96413, 96415, etc.). Always verify coverage and reimbursement policies with individual payers.